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• The role of vertebroplasty or kyphoplasty for the treatment related to vertebral fractures withor without pathologic tumor invasion.• The rationale for using intrathecal or epidural drug administration, the available evidence,potential complications, drug selection and technical aspects.• The algorithm for treatment selection for cancer pain.Key Points• The cornerstone for the management of cancer pain is pharmacologic treatment according tothe WHO pain ladder.• Treatment outcome should be measured in terms of pain reduction but also quality of life.• Side effects may seriously compromise the quality of life and/or limit the dose increase ofmedication.• Celiac plexus and splanchnic nerve block are procedures that are documented to reducepain and the need for opioids, moreover, these interventions can be repeated when the painreturns, without increased risk for complications or loss of efficacy.• Cervical cordotomy is indicated for the management of, preferentially unilateral pain at thelevel below the dermatome C5. The potential complications justify to reserve this treatmentfor patients with a life expectancy of less than 1 year.• The use of plexus hypogastricus block for patients with extensive tumors in the small pelvis wasonly documented in observational studies, reporting significant pain reduction in about 60%of the patients. This is a relatively safe technique• The use of lower end block, this technique can only be considered in patients who experiencepain in the small pelvis and who have lost normal bladder and/or rectal function.• Bone metastases can be the cause of vertebral compression fractures. There is evidence that thevertebroplasty and kyphoplasty reduce pain and improve functionality. When performed byan experienced operator these procedures are relatively safe.• The principle of intrathecal drug administration relies on the fact that the drug is administereddirectly at the site where the opioid receptors are present. In this way the analgesic dosecan be significantly reduced and side effects are limited. This drug administration methodhas been documented to be efficient for the treatment of cancer pain with a significantneuropathic component.• Epidural drug administration may be considered for a short treatment or for quick assessmentof the required dosages.• The treatment selection for patients with cancer pain should be based on the balance betweenefficacy and potential complications and side effects. It is imperative to exclude other causesof the pain, that may be treated by for example surgery, prior to perform an interventionalpain management technique. In the case of abdominal pain the celiac plexus block and/or thesplanchnic nerve block have been documented to reduce pain and the need for analgesics,thus rendering a better quality of life to the patient. These interventions may be consideredprior to starting opioid treatment.Raphael Justiz, MD, FIPPBiographical SketchDr Justiz earned a Bachelor and Masters in Sciences in Health Management from FloridaInternational University in Miami, Florida. He received his medical doctorate from Medicalcollege of Wisconsin in Milwaukee and completed his internship and residency in Internalmedicine and Anesthesiology at the University Of South Florida College Of Medicine in Tampa.His postdoctoral fellowship in Anesthesiology and Pain Management was completed at TexasTech University Health Sciences Center in Lubbock, Texas. Dr. Justiz remained on faculty aftercompleting his fellowship in pain management at the International Pain Institute at Texas TechUniversity Health Sciences Center.– 34–
Dr. Justiz is board certified in Anesthesiology, Interventional Pain Management and SportsMedicine, with multiple board certifications in pain medicine. He is board certified inanesthesiology by the American Board of Anesthesiology and has Added Qualifications in PainManagement by the same board. He is also pain boarded by the World Institute of Pain (FIPP),and American Board of Interventional Pain Physicians (ABIPP), and boarded by the AmericanCollege of Sports Medicine. Dr. Justiz is a member of numerous professional societies andassociations.Currently, Dr Justiz is the elected president and CEO of the Oklahoma Society of InterventionalPain Physicians, and is part of the guidelines writing committee for pain management for theAmerican Society of Interventional Pain Physicians.Dr. Justiz is also a pain management consultant/speaker for St. Jude Medical NeuromodulationDivision, Anulex Technologies, and a developer of soft tissue repair products used in spinaltreatments.Dr. Justiz has published multiple book chapters and journal articles. His areas of interest includeperipheral field/spinal cord stimulation and treatment of refractory head and facial pain andengages in ongoing research studies on neuromodulation for the treatment of pain.LectureSpinal Stenosis – New Methods for TreatmentObjectivesUpon completion of this presentation attendees will be able to discuss• Spinal Stenosis• Clinical Presentation• Treatment options for Stenosis• Minimally Invasive Lumbar Decompression• Identify patient and workup• How to perform MILD procedure• Evidence• ComplicationsKey Points• Discuss spinal Stenosis including risk factors, epidemiology, its economic effects and clinicalconsequences. Look at the guidelines for determining spinal stenosis, and be able to recognizethe disease process and what treatment options there are available.• Discuss clinical presentation.• Discuss ideal patient selection and workup.• Discuss how minimally invasive lumbar decompression reduces pain and what mechanism areinvolved.• Look at the indications, contraindications and relative contraindications involved with minimallyinvasive lumbar decompression.• Discuss the different proper approach for MILD procedure. Look at the anatomical landmarksand proper imaging technique for safety. In detail define how the technique is performedincluding proper trajectory and access to ligamentum flavaum.• Discuss the most recent evidence for MILD• Recognize the common complications and practice safe techniques to avoid these complicationReferences1. Vogt MT, Cawthon PM, Kang JD, Donaldson WF, Cauley JA, Nevitt MC. Prevalence ofsymptoms of cervical and lumbar stenosis among participants in the OsteoporoticFractures in Men Study. Spine 2006 Jun 1;31(13):1445-51.2. Kalichman L, Cole R, Kim DH, Li L, Suri P, Guermazi A, Hunter DJ. Spinal stenosis prevalenceand association with symptoms: the Framingham Study. Spine J. 2009 Jul;9(7):545-50.– 35–
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Page 3 and 4: ContentGreetings...................
Page 5 and 6: speakers. The local arrangements ch
Page 7 and 8: Directors:Charles Amaral de Oliveir
Page 9 and 10: Registration Fee (Regular Fees afte
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Page 13 and 14: TUESDAY, 27 August, 2013 - Sofitel
Page 15: FIPP Awards CeremonyMaster of Cerem
Page 19 and 20: LectureLumbosacral Spinal Canal End
Page 21 and 22: LectureTarlov Cysts Plus Alternativ
Page 23 and 24: tissue inside the epidural space, m
Page 25 and 26: 1. Maigne JY, Aivakiklis A, Pfefer
Page 27 and 28: • By delivering RF in intermitten
Page 29 and 30: INNOVATION FOCUSED ON PAIN RELIEF C
Page 31 and 32: • Frank J. Erbguth (2004). “His
Page 33: • Levels of exposure. Work-relate
Page 37 and 38: Andrea M. Trescot, MD, FIPPBiograph
Page 39 and 40: Sang Chul Lee, MD, MD, PhD, FIPPBio
Page 41 and 42: Introducing our newcorporate websit
Page 43 and 44: Epimed International Inc.Crossroads
Page 45 and 46: AUTHORS INDEXMert Akbas............
Page 47 and 48: Big thingscome in smallpackages.Wit

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